<form id="edit-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">
    <fieldset>
        <legend>
            订单编号：{$info.order_number}
            {if $info.status == 2}
            <span style="color: red; margin-left: 10px; font-size: 14px;">({$info.state_text})</span>
            {/if}
        </legend>
        <div>
            <div class="form-group">
                <label class="control-label col-xs-12 col-sm-2">订单编号：</label>
                <div class="col-xs-12 col-sm-8 p-t-7">
                    {$info.order_number}
                </div>
            </div>
            <div class="form-group">
                <label class="control-label col-xs-12 col-sm-2">机构：</label>
                <div class="col-xs-12 col-sm-8 p-t-7">
                    {$info.company}
                </div>
            </div>
            <div class="form-group">
                <label class="control-label col-xs-12 col-sm-2">代理：</label>
                <div class="col-xs-12 col-sm-8 p-t-7">
                    {$info.sales}
                </div>
            </div>
            <div class="form-group">
                <label class="control-label col-xs-12 col-sm-2">提现通道：</label>
                <div class="col-xs-12 col-sm-8 p-t-7">
                    {$info.withdrawal_channel}
                </div>
            </div>
            <!-- <div class="form-group">
                <label class="control-label col-xs-12 col-sm-2">提现类型：</label>
                <div class="col-xs-12 col-sm-8 p-t-7">
                    {$info.balance_type}
                </div>
            </div> -->
            <div class="form-group">
                <label class="control-label col-xs-12 col-sm-2">结算方式：</label>
                <div class="col-xs-12 col-sm-8 p-t-7">
                    {$info.clearing_form}
                </div>
            </div>
            <div class="form-group">
                <label class="control-label col-xs-12 col-sm-2">提现金额：</label>
                <div class="col-xs-12 col-sm-8 p-t-7">
                    {$info.withdrawal_money}
                </div>
            </div>
            <div class="form-group">
                <label class="control-label col-xs-12 col-sm-2">手续费：</label>
                <div class="col-xs-12 col-sm-8 p-t-7">
                    {$info.service_charge}
                </div>
            </div>
            <div class="form-group">
                <label class="control-label col-xs-12 col-sm-2">服务费：</label>
                <div class="col-xs-12 col-sm-8 p-t-7">
                    {$info.tax_rate}
                </div>
            </div>
            <div class="form-group">
                <label class="control-label col-xs-12 col-sm-2">税金：</label>
                <div class="col-xs-12 col-sm-8 p-t-7">
                    {$info.tax_rate_money}
                </div>
            </div>
            <div class="form-group">
                <label class="control-label col-xs-12 col-sm-2">到账金额：</label>
                <div class="col-xs-12 col-sm-8 p-t-7">
                    {$info.arrival_amount}
                </div>
            </div>
            <div class="form-group">
                <label class="control-label col-xs-12 col-sm-2">提现时间：</label>
                <div class="col-xs-12 col-sm-8 p-t-7">
                    {$info.create_time}
                </div>
            </div>
        </div>
    </fieldset>
    <fieldset>
        <legend>银行卡信息</legend>
        <div>
            <div class="form-group">
                <label class="control-label col-xs-12 col-sm-2">姓名：</label>
                <div class="col-xs-12 col-sm-8 p-t-7">
                    {$info.name}
                </div>
            </div>
            <div class="form-group">
                <label class="control-label col-xs-12 col-sm-2">预留手机号：</label>
                <div class="col-xs-12 col-sm-8 p-t-7">
                    {$info.phone}
                </div>
            </div>
            <div class="form-group">
                <label class="control-label col-xs-12 col-sm-2">身份证号：</label>
                <div class="col-xs-12 col-sm-8 p-t-7">
                    {$info.idcards}
                </div>
            </div>
            <div class="form-group">
                <label class="control-label col-xs-12 col-sm-2">银行卡号：</label>
                <div class="col-xs-12 col-sm-8 p-t-7">
                    {$info.bank_card_number}
                </div>
            </div>
        </div>
    </fieldset>
    <fieldset>
        <legend>订单状态</legend>
        <div>
            <div class="form-group">
                <label class="control-label col-xs-12 col-sm-2">订单状态：</label>
                <div class="col-xs-12 col-sm-8 p-t-7">
                    {$info.state_text}
                </div>
            </div>
            <div class="form-group">
                <label class="control-label col-xs-12 col-sm-2">审核状态：</label>
                <div class="col-xs-12 col-sm-8 p-t-7">
                    {$info.audit_status_text}
                </div>
            </div>
            {if $info.audit_status == 2}
            <div class="form-group">
                <label class="control-label col-xs-12 col-sm-2">审核时间：</label>
                <div class="col-xs-12 col-sm-8 p-t-7">
                    {$info.audit_time}
                </div>
            </div>
            {/if}
            <div class="form-group">
                <label class="control-label col-xs-12 col-sm-2">代付状态：</label>
                <div class="col-xs-12 col-sm-8 p-t-7">
                    {if $info.audit_status == 2}
                    {$info.payment_status_text}
                    {else /}
                    {$info.audit_status_text}
                    {/if}
                </div>
            </div>
            {if $info.payment_status == 2}
            <div class="form-group">
                <label class="control-label col-xs-12 col-sm-2">代付时间：</label>
                <div class="col-xs-12 col-sm-8 p-t-7">
                    {$info.payment_time}
                </div>
            </div>
            {/if}
            <div class="form-group">
                <label class="control-label col-xs-12 col-sm-2">备注信息：</label>
                <div class="col-xs-12 col-sm-8 p-t-7">
                    {if $info.remarks != ''}
                    {$info.remarks}
                    {else /}
                    无
                    {/if}
                </div>
            </div>
        </div>
    </fieldset>
    {if $info.payment_status > 1}
    <fieldset>
        <legend>接口信息</legend>
        <div>
            <div class="form-group">
                <label class="control-label col-xs-12 col-sm-2">接口手续费：</label>
                <div class="col-xs-12 col-sm-8 p-t-7">
                    {$info.port_service_fee}
                </div>
            </div>
            <div class="form-group">
                <label class="control-label col-xs-12 col-sm-2">接口信息：</label>
                <div class="col-xs-12 col-sm-8 p-t-7">
                    {$info.port_content}
                </div>
            </div>
        </div>
    </fieldset>
    {/if}
</form>
<style>
    .p-t-7 {
        padding-top: 7px;
    }
</style>